To compare the Health Star Rating (HSR) and the nutritional profile of branded and generic packaged foods in Australia.

In-store audits of packaged food products capturing data on HSR and nutritional content to analyse differences between branded and generic foods across ten food categories.

The audit was conducted in four major supermarket chains across various locations within metropolitan Sydney regions, Australia.

A total of 6269 products were analysed with 57 % of generic products and 28 % of branded products displaying an HSR. The median HSR of branded products was significantly greater than for generic products overall (4·0 v. 3·5, P<0·005) and in six out of ten food categories (P<0·005). However, when branded products could be matched to their generic counterparts for paired comparisons (n 146), no statistical difference was observed in all ten food categories. Branded products that chose to display an HSR had significantly lower saturated fat and Na, but higher fibre contents than branded products not displaying an HSR.

Our data show no difference in the HSR or nutrient profiles of similar branded and generic products that display HSR. Branded products appear to exploit the voluntary nature of the HSR scheme, preferentially displaying an HSR on healthier products compared with their generic counterparts.

Analysing dietary data to capture how individuals typically consume foods is dependent on the coding variables used. Individual foods consumed simultaneously, like coffee with milk, are given codes to identify these combinations. Our literature review revealed a lack of discussion about using combination codes in analysis. The present study identified foods consumed at mealtimes and by race when combination codes were or were not utilized.

Duplicate analysis methods were performed on separate data sets. The original data set consisted of all foods reported; each food was coded as if it was consumed individually. The revised data set was derived from the original data set by first isolating coded foods consumed as individual items from those foods consumed simultaneously and assigning a code to designate a combination. Foods assigned a combination code, like pancakes with syrup, were aggregated and associated with a food group, defined by the major food component (i.e. pancakes), and then appended to the isolated coded foods.

Healthy Aging in Neighborhoods of Diversity across the Life Span study.

African-American and White adults with two dietary recalls (n 2177).

Differences existed in lists of foods most frequently consumed by mealtime and race when comparing results based on original and revised data sets. African Americans reported consumption of sausage/luncheon meat and poultry, while ready-to-eat cereals and cakes/doughnuts/pastries were reported by Whites on recalls.

Use of combination codes provided more accurate representation of how foods were consumed by populations. This information is beneficial when creating interventions and exploring diet–health relationships.

To evaluate the association between weight status and food insecurity of children living in social vulnerability who are beneficiaries of a food assistance programme (FAP).

Cross-sectional study.

From all children benefiting from the FAP in the municipality, 30 % were mapped in forty-seven distribution points. Their weight status was evaluated using BMI-for-age and food insecurity was determined with the Brazilian Food Insecurity Scale. Socio-economic data of the participants were collected using regular questionnaires. The main outcome measure was obesity.

To be a beneficiary of the FAP, a family must have a child aged 24–96 months and receive less than half a minimum wage per capita. Participating families receive 1 litre of whole milk per day.

In all, 1487 children had BMI-for-age and food insecurity data. Of these children, 376 (25·3 %) had excess weight, of whom 164 (11·0 %) presented with obesity, and only twenty-seven (1·8 %) were underweight; 76 % of the families had some degree of food insecurity. Multivariable analysis revealed no overall association between household food insecurity and weight status. In the specific comparison, children living in severe food insecurity were less likely to present obesity than those children living in food security (prevalence ratio = 0·60; 95 % CI 0·38, 0·96; P = 0·03).

In a socially vulnerable population that participates in a FAP, there was no overall association between food insecurity and weight status in children, a result which is similar to what is observed in more developed contexts.

This study assesses the prevalence of childhood undernutrition from 2001 to 2016 and estimate projections of undernutrition for 2016–2030 in Nepal.

The study used data from four rounds of a cross-sectional survey of Nepal Demographic and Health Survey (NDHS) conducted in 2001, 2006, 2011 and 2016. Descriptive analyses were conducted to calculate prevalence, binary logistic regression was used to test the significance of trends over time and autoregressive integrated moving average model was used to forecast the prevalence of childhood undernutrition.

The children and household member datasets from four NDHS were merged to assess the trends of childhood undernutrition in Nepal.

A total of 16 613 children (8399 male and 8214 female) under 5 years of age were selected for anthropometric measurements using a stratified cluster random sampling method.

Overall results show a decline in prevalence of stunting from 57·2 % to 35·8 % (P < 0·001), underweight from 42·7 % to 27 % (P < 0·001) and wasting from 11·2 % to 9·7 % (P < 0·05) from 2001 to 2016. However, different population subgroups have a higher prevalence of undernutrition than national average. Further, the analyses show that the prevalence of stunting will decline to 14·3 % and wasting to 8·4 % by 2030.

A remarkable decrease in the prevalence of stunting and underweight has been observed over the last 15 years. Nepal is likely to achieve the nutritional targets for stunting but not for wasting by 2030. Given large subpopulation variations, further improvement in undernutrition require more specific, targeted and localised programmes.

The Global Burden of Disease (GBD) Study provides estimates of death and disability from eighty-seven risk factors, including some micronutrient deficiencies.

To review methodological changes that led to large differences in the disease burden estimates for vitamin A and Zn deficiencies between the GBD 2017 and 2019 Studies.

GBD publications were reviewed; additional information was provided by GBD researchers.

Vitamin A deficiency prevalence is based on plasma retinol concentration, whereas the estimate for Zn deficiency prevalence uses dietary adequacy as a proxy. The estimated global prevalence of vitamin A deficiency for children aged 1–4 years in the year 2017 decreased from 0·20 (95 % CI 0·17, 0·24) in GBD 2017 to 0·16 (95 % CI 0·15, 0·19) in GBD 2019, while the global prevalence of Zn deficiency did not change between the two studies (0·09 (95 % CI 0·04, 0·17) and 0·09 (95 % CI 0·03, 0·18)). New to 2019 was that meta-analyses were performed using Meta Regression – Bayesian, Regularized, Trimmed, a method developed for GBD. Due to this and multiple other methodological changes, the estimated number of deaths due to vitamin A deficiency dropped from 233 000 (179 000–294 000) to 24 000 (3000–50 000) from GBD 2017 to 2019, and for Zn deficiency from 29 000 (1000–77 000) to 2800 (700–6500), respectively.

The changes in the estimated disease burdens due to vitamin A and Zn deficiencies in the GBD reports from 2017 to 2019 are due primarily to changes in the analytical methods employed, so may not represent true changes in disease burden. Additional effort is needed to validate these results.

In this study, socio-economic factors associated with Afghan refugee households’ food insecurity, anxiety and uncertainty, insufficient quality and food intake were determined.

Household Food Insecurity Assess Scale measurement was applied to assess food insecurity, anxiety and uncertainty, insufficient quality and insufficient food intake. Descriptive analysis and multivariable regression models were used to determine the associated factors.

The study was carried out in urban areas of Tehran province in Iran.

To collect data, interviews were conducted among 317 Afghan households. The questionnaire was administered via face-to-face interviews to either the breadwinner of the selected households or a member who could respond on behalf of the household.

About 11·3 % of Afghan households who resettled in Tehran province were food secure, while 11·7 % were marginally, 40·7 % moderately and 36·3 % severely food insecure. Economic and financial factors were inversely and significantly associated with food insecurity. Employment, income, distance from the central market and personal saving were inversely associated with food insecurity, while other determinants, including the length of living time in Tehran, house type and the number of male and female children, had a direct association with food insecurity.

The associations of socio-economic factors with three categories of food insecurity differed. Elimination of occupation bans that the Iranian government imposes on refugees provides simple access to financial supports like long-term loans, and opening a bank account for refugees will benefit both Iranians and refugees.

In 2014, a Nutrition Report Card (NRC) was developed as a sustainable, low-cost framework to assess the healthfulness of children’s food environments and highlight action to support healthy eating. We summarise our experiences in producing, disseminating, evaluating and refining an annual NRC in a Canadian province from 2015 to 2019.

To produce the NRC, children’s food environment indicator data are collected, analyzed and compiled for consensus grading by an Expert Working Group of researchers and practitioners. Knowledge translation activities are tailored annually to the needs of target audiences: researchers, practitioners, policymakers and the public. Evaluation of reach is conducted through diverse strategies, including tracking media coverage and website traffic. Assessment of impact on diets and health outcomes is planned.

Alberta, Canada.

Not applicable.

The grading process has facilitated refining the NRC to enhance its relevance and utility as a tool for its target audiences. Its public release consistently captures media interest and policymakers’ attention. The importance of partnerships in revealing data sources and in strategising to enhance policy approaches to improve food environments is apparent. The NRC has benchmarked progress and stimulated dialogue regarding healthy food environments for children.

The NRC may help to foster a supportive climate for improving the quality of children’s food environments. As an engaging and accessible document, the NRC represents a key mechanism for collating data related to children’s food environments and ensuring it reaches the audiences best positioned to use it. Efforts are underway to expand the NRC across Canada.

To investigate biomarkers of nutrition associated with chronic disease absence for an Aboriginal cohort.

Screening for nutritional biomarkers was completed at baseline (1995). Evidence of chronic disease (diabetes, CVD, chronic kidney disease or hypertension) was sought from primary health-care clinics, hospitals and death records over 10 years of follow-up. Principal components analysis was used to group baseline nutritional biomarkers and logistic regression modelling used to investigate associations between the principal components and chronic disease absence.

Three Central Australian Aboriginal communities.

Aboriginal people (n 444, 286 of whom were without chronic disease at baseline) aged 15–82 years.

Principal components analysis grouped twelve nutritional biomarkers into four components: ‘lipids’; ‘adiposity’; ‘dietary quality’; and ‘habitus with inverse quality diet’. For the 286 individuals free of chronic disease at baseline, lower adiposity, lower lipids and better dietary quality components were each associated with the absence at follow-up of most chronic diseases examined, with the exception of chronic kidney disease. Low ‘adiposity’ component was associated with absence of diabetes, hypertension and CVD at follow-up. Low ‘lipid’ component was associated with absence of hypertension and CVD, and high ‘dietary quality’ component was associated with absence of CVD at follow-up.

Lowering or maintenance of the factors related to ‘adiposity’ and ‘lipids’ to healthy thresholds and increasing access to a healthy diet appear useful targets for chronic disease prevention for Aboriginal people in Central Australia.

Breakfast has been linked to several aspects of health, yet breakfast skipping is rampant across the globe. Studies in India have focused mostly on children. Hence the present study examined breakfast behaviour across different age and gender groups.

Cross-sectional sample, purposive sampling. Nutrient intakes of the participants derived from 24 h dietary recall and 3 d breakfast record data were compared with RDA values prescribed by the Indian Council of Medical Research using Student's t test, with P < 0·05 taken to indicate significance.

Mumbai, India.

Participants (n 1027) aged 8 years and above.

Nutritional adequacy of the breakfast meal and that of the day's diet were the main outcome measures. Eighty-one per cent of the participants had a nutritionally inadequate breakfast. Intakes of Fe and dietary fibre were notably low. Consumption of just milk or milk plus a milk food-based drink among schoolchildren (49 %) and increased breakfast skipping among adolescents (37 %) were seen.

The study identifies both irregularities and/or nutritional inadequacies with respect to the breakfast meal. Age- and gender-specific challenges in breakfast behaviour need to be addressed. Development of ‘nutrient-dense’ breakfast foods that can be prepared easily, school breakfast programmes and education on the importance of breakfast are the needs of the hour.

To review evidence on the associations between vitamin B12 intake and its biomarkers, vitamin B12 intake and its functional health outcomes, and vitamin B12 biomarkers and functional health outcomes.

A systematic review was conducted by searching electronic databases, until January 2012, using a standardized strategy developed in the EURRECA network. Relevant articles were screened and sorted based on title and abstract, then based on full text, and finally included if they met inclusion criteria. A total of sixteen articles were included in the review.

Articles covered four continents: America (n 4), Europe (n 8), Africa (n 1) and Asia (n 3).

Population groups included healthy infants, children and adolescents, and pregnant and lactating women.

From the total number of 5815 papers retrieved from the initial search, only sixteen were eligible according to the inclusion criteria: five for infants, five for children and adolescents, and six for pregnant and lactating women.

Only one main conclusion could be extracted from this scarce number of references: a positive association between vitamin B12 intake and serum vitamin B12 in the infant group. Other associations were not reported in the eligible papers or the results were not provided in a consistent manner. The low number of papers that could be included in our systematic review is probably due to the attention that is currently given to research on vitamin B12 in elderly people. Our observations in the current systematic review justify the idea of performing well-designed studies on vitamin B12 in young populations.

To examine changes in energy intake along with markers of dietary quality (animal-source energy and protein intakes) among household members in the presence of supplementary school feeding in rural Kenya.

A 2-year, longitudinal, randomized controlled feeding intervention study.

Kyeni South Division, Embu District, Kenya.

A total of 182 schoolchildren and selected household members.

There was no evidence that schoolchildren who received supplementary snacks at school experienced reduced intakes at home or that intakes by other family members were increased at the expense of the schoolchild's intake.

This analysis highlights a number of factors useful in planning for supplementary feeding interventions in rural Kenya and similar communities.

To identify cut-off points for waist circumference (WC), waist-to-height ratio (WHtR) and BMI associated with hypertension in the Brazilian adult and elderly population.

Cross-sectional study. The receiver-operating characteristic (ROC) curve was used to determine the cut-off points of WC, WHtR and BMI in the prediction of hypertension. Those who had systolic blood pressure ≥140 mmHg and/or diastolic blood pressure ≥90 mmHg and those who reported use of antihypertensive medication were considered hypertensive.

Brazil.

Participants from the National Health Survey, the Brazilian household-based survey conducted in 2013, of both sexes and age ≥20 years.

Cut-off points for WC and WHtR increased with age in both sexes. WC cut-off limits ranged between 88·0 and 95·9 cm in men and between 85·0 and 93·2 cm in women. For WHtR, cut-off scores ranged from 0·51 to 0·58 for men and from 0·53 to 0·61 for women. Additionally, the area under the ROC curve (AUC) for all age and sex groups was greater than 0·60 while the lower limit of the AUC 95 % CI for both WC and WHtR was not less than 0·50. The performance of BMI was similar to that of indicators of fat location.

All analysed anthropometric indicators had similar performance in identifying hypertension in the Brazilian population.

To identify the corporate political activity (CPA) strategies used by food industry actors during the development of two public health nutrition policies in Central America: Law #570 (taxation of sugar-sweetened beverages) in Panama and Bill #5504 (labelling and food marketing regulations) in Guatemala.

We triangulated data from publicly available information from 2018 to 2020, (e.g. industry and government materials; social media material) with semi-structured interviews with key stakeholders.

Guatemala and Panama.

Government, academia and international organisations workers in health and nutrition.

CPA strategies were categorised according to an existing internationally used taxonomy into action-based, instrumental strategies (coalition management, information management, direct involvement and influence in policy, legal action) and discursive strategies.

Instrumental strategies included the establishment of relationships with policymakers and direct lobbying against the proposed public policies. Discursive strategies were mainly criticising on the unfounded ground that they lacked evidence of effectiveness and will imply negative impacts on the economy. The industry pointed at individuals for making their own food choices, in order to shift the focus away from the role of its products in contributing to ill health.

We provide evidence of the political practices used by the food industry to interfere with the development and implementation of public health nutrition policies to improve diets in Central America. Policymakers, public health advocates and the public should be informed about those practices and develop counterstrategies and arguments to protect the public and policies from the vested interests of the food industry.

The present study investigated the association between sugar and fat intake in childhood in relation to alcohol use in adolescence. We hypothesized that early exposure to diets high in fat and sugar may affect ingestive behaviours later in life, including alcohol use.

Children from the European IDEFICS/I.Family cohort study were examined at ages 5–9 years and followed up at ages 11–16 years. FFQ were completed by parents on behalf of children, and later by adolescents themselves. Complete data were available in 2263 participants. Children’s propensities to consume foods high in fat and sugar were calculated and dichotomized at median values. Adolescents’ use of alcohol was classified as at least weekly v. less frequent use. Log-binomial regression linked sugar and fat consumption in childhood to risk of alcohol use in adolescence, adjusted for relevant covariates.

Five per cent of adolescents reported weekly alcohol consumption. Children with high propensity to consume sugar and fat were at greater risk of later alcohol use, compared with children with low fat and low sugar propensity (relative risk=2·46; 95 % CI 1·47, 4·12), independent of age, sex and survey country. The association was not explained by parental income and education, strict parenting style or child's health-related quality of life and was only partly mediated by sustained consumption of sugar and fat into adolescence.

Frequent consumption of foods high in fat and sugar in childhood predicted regular use of alcohol in adolescence.

Health inequities such as chronic disease are significantly higher among individuals living with disadvantage compared with the general population and many are reported to be attributable to preventable dietary risk factors. This study provides an overview of the current nutrition interventions for individuals living with extreme disadvantage, in supported residential settings, to develop insights into the development and implementation of policies and practices to promote long-term nutritional health and well-being.

A scoping review searched Scopus, ProQuest, CINAHL Plus, MEDLINE, and Web of Science databases using the terms ‘resident’, ‘nutrition’, ‘disadvantage’, ‘intervention’ and their synonyms, with particular emphasis on interventions in residential settings.

Residential services providing nutrition provision and support.

People experiencing extreme disadvantage.

From 5262 articles, seven were included in final synthesis. Most interventions focused on building food literacy knowledge and skills. Study designs and outcome measures varied; however, all reported descriptive improvements in behaviour and motivation. In addition to food literacy, it was suggested that interventions need to address behaviour and motivations, programme sustainability, long-term social, physical and economic barriers and provide support for participants during transition into independent living. Socio-economic issues remain key barriers to long-term health and well-being.

In addition to food literacy education, future research and interventions should consider utilising an academic-community partnership, addressing nutrition-related mental health challenges, motivation and behaviour change and a phased approach to improve support for individuals transitioning into independent living.

To identify temporal patterns of sleep and eating among school-age children during school closure due to the COVID-19 pandemic and to examine their associations with lifestyle behaviours and dietary intake.

In this cross-sectional study, questionnaires were used to assess sleep and eating times, lifestyle behaviours and dietary intake during school closure. Latent class analysis was performed to identify temporal patterns of sleep and eating based on self-reported clock times for wake-up, going to bed and eating meals. Lifestyle behaviours and dietary intake were compared between latent classes.

Forty-eight primary and secondary schools in Japan.

Totally, 6220 children (aged 8–15 years).

Four patterns, labelled ‘Very early (20 % of children)’, ‘Early (24 %)’, ‘Late (30 %)’ and ‘Very late (26 %),’ were identified and ordered according to the circadian timing. Latter patterns were characterised by later timings of sleep and eating, especially in clock times for wake-up, breakfast and lunch compared with earlier patterns. Children with latter patterns had a less physically active lifestyle, longer screen time (≥4 h/d), shorter study time (<2 h/d) and more frequent skipping of breakfast and lunch than those with earlier patterns. In addition, children with latter patterns had lower intakes of several vitamins, vegetables, fruits, fish and shellfish and dairy products and higher intakes of sugar and confectionaries and sweetened beverages.

More than half of the participants had later wake-up, breakfast and lunch during school closure, which was associated with more unfavourable lifestyles and dietary intakes.

To investigate the possible associations between the food environment and dietary intake in the Mexican population.

Four databases (PubMed, PsychInfo, Web of Science and SCIelo) were used to retrieve relevant articles using an open timeframe. Articles were reviewed if they contained a systematic measure (i.e. food checklist) of the food environment (e.g. food availability) and dietary intake.

Urban and rural communities in Mexico.

Population-based studies of Mexican communities.

Twenty studies that assessed at least one food environment level, and at least one dietary outcome, were reviewed. Findings from these studies showed that changes in the Mexican food environment seem to be associated with higher availability of energy-dense foods. Energy-dense foods can be linked to a high consumption in household, environment and community food environments. When both nutrient-dense and energy-dense foods were present, individuals were more likely to consume foods with added sugars, fats and salt options than nutrient-dense items.

The various levels of the food environment (i.e. household, school, community) exposed participants to energy-dense foods. Although nutrient-dense foods were present in all three levels, individuals were more likely to consume energy-dense food items. Not all three levels of the food environment are well represented in the urban and rural settings. Most studies on the community food environment were done in rural areas, whereas most studies on the school food environment were done in urban settings. Additional rigorously designed studies are needed to document the relationship between the food environment and dietary intake in the Mexican population.

To determine whether dietetic students would report a change in their public service motivation (PSM) following a community nutrition service learning (SL) course, and whether the SL model (charity v. project) influences this change differently.

Using a pretest–posttest, nonequivalent groups quasi-experimental design, this study compared students’ PSM at the beginning and end of a 15-week college-level course. PSM and four component dimensions (attraction to public policy, commitment to public interest, compassion and self-sacrifice) were measured via electronic survey using the PSM scale. Average PSM scores were compared between and within the charity and project groups using independent samples and paired sample t tests, respectively. ANCOVA assessed the effect of SL model on post-survey scores, controlling for pre-survey scores.

Public university in northeastern United States.

Dietetic students enrolled in six sections of the same undergraduate community nutrition SL course. Students were placed by section in either charity (n 59) or project (n 52) SL experiences and required to complete 14 h in this role.

Mean PSM total scores increased between pre-survey and post-survey (3·50 v. 3·58; P = 0·001). Students reported small increases in three PSM dimensions: commitment to public interest, compassion and self-sacrifice (all P ≤ 0·01). Holding pre-scores constant, the charity group reported a higher attraction to public policy post-score, while the project group reported a higher self-sacrifice post-score (both P < 0·05).

Educators should consider adopting SL methods into curricular offerings to enhance students’ motivation for public service.